Healthcare Provider Details

I. General information

NPI: 1851210249
Provider Name (Legal Business Name): HEATHER MINTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8117 SANDY POINT RD
BRYAN TX
77807-8195
US

IV. Provider business mailing address

8117 SANDY POINT RD
BRYAN TX
77807-8195
US

V. Phone/Fax

Practice location:
  • Phone: 979-450-0065
  • Fax:
Mailing address:
  • Phone: 979-450-0065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103823
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: